Abstract / Summary
Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder characterized by progressive proximal muscle weakness and atrophy. Anesthetic management in obstetric patients with neuromuscular conditions requires careful planning, particularly in the presence of previous postdural puncture headache (PDPH) and concurrent respiratory symptoms. A pregnant woman with SMA carrier status was scheduled for cesarean section due to repeat cesarean delivery, gestational hypertension, and premature rupture of membranes. Her obstetric history included a missed abortion at 12 weeks and PDPH following spinal anesthesia during a prior cesarean section. She also presented with a five-day history of cough and postnasal drip. Considering her refusal of spinal anesthesia and the potential risks associated with general anesthesia, epidural anesthesia was administered, avoiding neuromuscular blocking agents and tracheal intubation. Epidural anesthesia may represent a safe and effective alternative for cesarean delivery in selected obstetric patients with SMA carrier status and prior PDPH history.